Master Plan for Aging: An age- and disability-friendly California

Rome wasn’t built in a day, but the Romans laid bricks every hour. The same might be said about California’s Master Plan for Aging, which has laid the groundwork for this precise moment in time.

The Master Plan for Aging (MPA), a roadmap for creating equitable and transformative systems of care for our aging population, recently celebrated its first anniversary of unprecedented investments in aging and disability across housing, health care, long-term services and supports, the geriatric workforce, Alzheimer’s disease, family caregiving, and more.

The 2021-22 enacted budget contained meaningful investments for the MPA, including enhanced funding for California’s Home- and Community-Based Services (HCBS) Spending Plan,

The MPA is not just another report that will be cast aside. It is designed to be reevaluated and built upon as the needs of California’s aging population evolve.

Most recently, new data from the California Department of Health Care Services showed that Medicare enrollment among Californians older than age 65 grew by over 11 percent over the past five years. Our older adults’ ability to access long-term services and support will need to be a top priority in the years to come, and the MPA will help us achieve those goals.

California is leading the way, with a governor taking this issue as his, and while more must be done to close the systematic gaps, we are on the course toward solutions and change.

The 2021-22 enacted budget contained meaningful investments for the MPA, including enhanced funding for California’s Home- and Community-Based Services (HCBS) Spending Plan, made available through the American Rescue Plan Act of 2021.

Philanthropy, advocates, academics, and private and local partnerships took the time to create a movement and, more importantly, a plan to become the nation’s most age- and disability-friendly state.

California received approval for a $4.6 billion HCBS Spending Plan from the Centers for Medicare and Medicaid Services, which will enhance our caregiving workforce and navigation systems and build capacity and models of care.

Additionally, under the 2021-22 budget, California created the Office of Medicare Innovation and Integration, doubled down on investments to successfully implement California Advancing and Innovating Medi-Cal (CalAIM), and funded several direct care workforce initiatives.

These considerable investments don’t just happen overnight. It takes planning and ‘laying the bricks’ to secure such funding.

Philanthropy, advocates, academics, and private and local partnerships took the time to create a movement and, more importantly, a plan to become the nation’s most age- and disability-friendly state. They have seized the moment and secured billions of federal dollars for Californians. We must increase the visibility of these investments for continuing momentum.

The state is at the center of the action by maximizing federal dollars while at the same time working hand in glove with local governments and systems to create a more focused approach to care.

Local partnerships strengthened in 2021 as cities, counties, and regions have come together to build their own communities for all ages and abilities.

Since its launch in January 2021, the California Department of Aging, community-based and philanthropic organizations, and more than 20 local and regional communities have convened events and local forums to educate local leaders and the interested public about the Master Plan for Aging. These events have created a groundswell of interest in identifying and prioritizing key MPA focus areas to address locally.

Many local coalitions and workgroups are in the process of developing strategic plans for implementation, such as “Caregiving that Works” in Los Angeles and a zero-tolerance policy for older adults experiencing homelessness in San Francisco, to name a few.

Similarly, California mayors and county supervisors in 64 jurisdictions, representing nearly 23 million residents, joined AARP’s Network of Age-Friendly States & Communities and committed to a five-year process to create communities where people of all ages can thrive throughout their lives. In 2021, California became the 8^th state to join the Network with the MPA goals driving ongoing work required to achieve the long-term change envisioned in the MPA.

And now, in Governor Newsom’s proposed 2022-23 budget, there are more investments to continue building the foundation, such as:

• $1.7 billion over three years to create opportunities to expand, support, and diversify the health and human services workforce to create a more equitable care economy.
• $10 million for the Alzheimer’s Healthy Brain Initiative to support existing grantees in six local health jurisdictions and with an opportunity to expand up to six more.
• $2.8 billion to implement CalAIM, including managed care for dually eligible, long-term care integration into managed care, and Providing Access and Transforming Health funding to develop enhanced care management and community supports in CalAIM.

These are just a few initiatives and policies outlined in the governor’s budget to create a more equitable and accessible system of care for Californians. Now, California policymakers have the chance to double down and continue the momentum built by the MPA and the governor’s leadership.

Conquering systemic aging issues in our current state of reality isn’t easy, but we can now create our own Rome with the assembled leadership, collaboration, and discipline.

Let’s get the job done as time is running out.
—
Editor’s Note:  Dr. Sarita A. Mohanty, MD, MPH, MBA, is president and CEO of The SCAN Foundation. Nancy McPherson is state director of  AARP California.